WIRED Application 2023-2024

Student/Participant Information:
Note: if your student is a returning participant, please be careful to use the same spelling as prior applications)
Please do not use your K-12 school address
The best number to use for urgent messages
Parent or Legal Guardian Information, if you are 18 yrs or older, type SELF for these fields
Agreement

Assumption of Risk, Release, and Indemnity Agreement, Covid and Program Protocols

In consideration of the services of the The Pacific American Foundation, the State of Hawai'i, University of Hawai'i, Kamehameha Schools, Hawai'i Institute of Marine Biology, and all other related entities, partners, agents, directors, advisors, officers, employees, representatives, volunteers, and all other persons acting on behalf of these entities (hereinafter, collectively "PAF"), I hereby AGREE AND CONSENT TO WAIVE AND RELEASE, to relinquish, and to forever discharge PAF and its representatives on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate from any and all claims, any and all causes of action that I (we) have or may have, whether past, present or future, whether known or unknown, whether anticipated or unanticipated.


I understand that my participation in PAF activities whether on site or at any other site, ("Activities"), may involve conduct on, under, and/or around the ocean, streams, and mountain trails. 

Activities on the ocean may require the use of surfboards and other equipment, boats, or other ocean going vessels.  These activities are inherently dangerous, and involve unknown and unanticipated risks and dangers which could result in physical or emotional injury, paralysis, death, or damage to my person, property or other persons. Risks include, but are not limited to slips, falls, drowning, or other accidents.  The risks cannot be completely eliminated, without jeopardizing the essential qualities of the Activities.

I expressly agree to accept and assume all risks, and voluntarily elect to particpate in the Activities despite the risks and/or dangers.
 
I voluntarily release, forever discharge, and agree to hold harmless and indemnify PAF and all other persons or entities acting in any capacity on its behalf from any and all claims, demands, or causes of action, brought against me or against PAF, which are in any way connected with my participation in the Activities or my use of equipment or facilities, including without limitation any claims alleging negligent acts or omissions of PAF or its agents or representatives, any injury or loss whatsoever suffered by me during the periods of independent travel (which I understand are unsupervised), any financial or other obligations or liabilities that I may personally incur during the course of the Activities, any intentional or unintentional damage or injury to persons or property caused in whole or in part by me, and any injury or loss that I myself may suffer.

  Should PAF or anyone acting on its behalf be required to incur attorney's fees and costs to enforce this agreement, I agree to release, hold them harmless, and indemnify them for all such fees and costs.

  Medical: I hereby grant to PAF full authority to take whatever action it considers to be warranted in the case of a medical emergency, and I fully release PAF from any liability for such decision or actions as may be taken in connection therewith.  I authorize PAF to place me, at my own expense, in a hospital for medical services and treatment if necessary.  I also certify that I have adequate medical and other insurance to cover any injury or damage I may cause or suffer while participating in the Activities.  Alternatively, I agree to bear the full costs of such injury or damage myself.

  I certify that I have no medical or physical conditions that could interfere with my safety or the safety of other in the Activities, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition. If my condition changes during participation, I will notify PAF immediately, and I will be deemed to assume the risk and will bear the cost of those risks that may be created, directly or indirectly by any such condition if I continue participation. 

Swimming   I certify that I am qualified to swim in the open ocean. 

Conduct: I agree that I will follow the instructions and direction of PAF personnel at all times.  I agree that PAF shall have the right to enforce appropriate standards of conduct, and that it may at any time terminate my participation in the Activities for failure to maintain these standards or for any actions or conduct which PAF considers to be incompatible with the interest, harmony, comfort and welfare of the Activities and the other students.

Cancellations, Substitutions or Changes: PAF reserves the right to make cancellations, substitutions or changes in case of emergency or changed conditions, or in the interest of each group.  If performance of the Activities must be altered because of weather, strikes, government restrictions or regulations, act of God, or any other like reason, PAF shall have the right to make such alteration, or cancel part or all of the Activities, in its sole discretion. PAF shall determine the amount of any refund, in its sole discretion, and only those funds I have paid to PAF which have not actually been used or committed may be refunded to me.   I understand and agree that this agreement controls cancellation and reimbursement policies or provisions in any other agreement or publication by one of the collective PAF entities. 

Use of Own Equipment: If I use my own equipment, such as surfboards or snorkel equipment, I certify that this equipment has been properly maintained, is in good working condition, and that I am competent to use it in a safe and effective manner.

Venue and Choice of Law: I agree that any lawsuit I might file against PAF, I agree to file only in the State of Hawaiʻi and that the substantive law of the State of Hawaiʻi shall apply regardless of any conflict of law rules that might provide otherwise.  I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

I understand and agree that this Agreement and Release is binding and applies to any and all PAF activities that I may participate in, currently or in the future, whether I am participating minimally or fully in these activities now, and whether I undertake new activities with PAF anticipated or unanticipated at this time.  

Photo and Media Permission: I grant PAF permission to photograph and videotape or otherwise record and use images of myself and/or my child’s name, voice, and/or likeness, bibliographical identification, and/or work for educational purposes and for publicizing and promoting the Program and its activities.  The use of unmanned aerial systems (UAS) may be used to record imagery.

International travel: If part of PAF activities, travel has its own set of inherent risks. Please review the relevant US State Department sites relating to the proposed destination before participating in activities, as this agreement applies to these activities as well.  Travel medical and medical evacuation insurance must be obtained for each participant before travel begins, as a condition of participation.


COVID-19 Protocols for all participants: PAF is not responsible or accountable in the unlikely event of COVID-19 exposure during Activities. I agree that I will not attend face-to-face activities if I have any symptoms or test positive, for the protecction of others and their vulnerable family members.  

STUDENT AFFIRMATION: I have read and understand this agreement. I hereby agree and consent to waive and release, relinquish and forever discharge PAF,its representatives, agents, and all others acting on their behalf,  on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate, from all claims, any and all causes of action that I (we) have or may have, whether past, present or future, whether known or unknown, whether anticipated or unanticipated.


PARENT OR GUARDIAN REQUIRED if student is UNDER 18 years of age:  As the parent or legal guardian of the above signed student, I have read and understand this agreement. I hereby agree to waive and release, relinquish, and to forever discharge PAF and its representatives, agents, and all others acting on their behalf,  on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate from any and all claims, any and all causes of action that I (we) have or may have, whether past, present or future, whether known or unknown, whether anticipated or unanticipated.